Correcting a Pathologic Joint Position using Mandibular Torque and a Fixed Orthosis (part 2)
(Slide 1) We used the Myotronics K-7 to evaluate his function. (Slide 2) Scan 9 EMG of resting muscle groups showed elevated levels in his temporal is and cervical group. (Slide 3) After 60 minutes there was an improvement of resting EMG’s but the left cervical group remained elevated. (Slide 4)His clench scores remained low both with and without cotton rolls between his teeth. (Slide 5) There was excess freeway space and unstable occlusion, Scan 3. (Slide 6) Scan 2 shows dyskinesia. He had difficulty opening and was able to force himself to open to approximately 37 mm. (Slide 7, 8) The Sonography showed crepitus on both sides. (Slide 9) The existing anterior vertical dimension was 16mm when measured from tooth number eight to twenty five. There was an anterior/posterior discrepancy of 4.0mm in the saggital plane and 2.0mm in the frontal plane in scan 4/5. (Slide 10)The Myobite was taken at 18.8mm to construct a removable orthotic. The scans are an integral part of the diagnosis and treatment to discuss the scans in detail would require a lot more time.
(Slide 11) The I-CAT scan without the orthosis shows boney degeneration. (Slide 12) There is space between the condyle and the eminence, although there was still pain. (Slide 13, 14) On the left condyle in section 18, the condyle appears irregular. It would have been helpful to have the I-CAT in an open position especially when we consider his Sonography and the late crepitus. That might have revealed the dysfunction in his left TMJ.